I’m uncertain that there is any reason to consider it inadequate unless there is a treatment protocol that would be immediately implemented as soon as early changes were noted on angiograms, etc, that would otherwise not be implemented until some significant time later when changes were detected by a dilated ophthalmic exam. To my knowledge, that is not the case? If it’s not the case then it just seems like a good way to cause undue stress and worry and waste money…
I think I have plenty to occupy my attention for health concerns. Retinopathy, luckily for me, does not appear to be something to worry about.
18 years with diabetes and no trace yet in my eyes. I go next week for my annual dilated exam. Hopefully there will be no change.
I think we can be given a false sense of security about our eyes at times. If you go see some random optometrist for an eye exam he can see “obvious” signs of retinopathy, but he will me the small signs and changes. Even going to some random ophthalmologist runs the risk of only seeing a “snapshot” of your eyes. Retinopathy may not be detected early by a random snapshot exam that doesn’t use more advanced tests. Early retinopathy is characterized by leaking blood vessels unless you catch it at the examination it may not be seen and you can be declared “fine” only to find out later you had retinopathy that was finally caught as it got worse.
I see an opthamologist on a regular basis. The same one, for years. And he does advanced testing so that he can see any small problems and in particular any changes over time. As someone with diabetes, my opthamology visits are a medical visit and covered as such under my insurance (an optometrist is not a medical visit) and I take advantage of that.
I’m not saying that all you veterans don’t have perfect eyes, just that we need to be careful. An examination by an optometrist isn’t enough for us and even a so called “comprehensive dilated eye exam” is probably not a sufficient standard of care for someone with diabetes.
An optometrist, in my case at least, can also bill medical insurance if they code that they treated your diabetic retinopathy. In he case of optometrists, that usually means saying “you have retinopathy, you should control your diabetes… And from now on you need to come see me so I can bill your insurance every six months” whether you have any problems or not. This is why many optometrists purchase expensive retina photography equipment that they aren’t even qualified to use… It is a major system flaw that gives them incentives to falsely diagnose things… Happened to me…
Which is why I now only go to the same opthalmologist every year, who thus far anyway, has just done dialated scope exams… But I trust his judgement and when he feels that my history justifies something more elaborate I will certainly do it.
I agree that seeing an opthamologist is important. I have seen my 2 opthamologists , one a retinal specialist for many years. Nancy
Over my 45 years with this lovely disease, I have had my eyes check every single year. My biggest fear is losing my eye sight. I sit in that chair and am always in panic mode that the shoe is finally going to drop and I will get the bad news. After about 20 years I got the news of background bleeding. Nothing serious but something to watch. Started seeing the doctor twice a year and as my treatment plan got more on track, it disappeared. Two years ago I got the same diagnosis back ground bleeding but so minor it wasn’t worth doing extra test or pictures and to come back in a year. With the help of my CGM, we fined tuned even tighter and when I went back for the next visit, I was back to being clear. Now I know there reality is it may happen but now with all the advancements we have with treatments, I don’t have the panic fear. Fear, yes but not panic. I know while still being complication free right now, that doesn’t mean it will stay that way. I will continue to fight the fight and hopefully all those horrible things I was told with my poor parents back in 1970 will not happen. So far so good.
Side note when I had my first diagnosis of background bleeding my endocrinologist told my not to panic because they see that kind of bleeding usually around 10 years not 20. So while things have gotten better, we are still walking that very fine line. Complications or no complications. Wow, I really hate this disease!
I have been a well controlled type 2 for 9 years and was dx’d with non Proliferative retinopathy last year.
I probably did but I was in the best shape of my life. I workd out in the gym every day and ate a vegetarian diet. I had no family history of diabetes, either.
I’m shocked how little time elapsed between your T2D diagnosis and your retinopathy diagnosis. Your attention to working out and a good diet makes it even harder to understand. I think your habits and attention to your blood glucose will help you to slow down any retinopathy progression. Good luck to you.
I gotta ask… Were you diagnosed by an opthalmologist or an optometrist?
They are just watching it for now because my vision is fairly good with glasses. My Endo told me 25% of diabetics get complications even with good bgs. I also have some neuropathy and a condition called Diabetic Mastopathy and Diabetic macular edema.
My Optomotrist dx’d me at my annual exam when he dilated my eyes. Then they had me look into a machine that took color pictures of my retinas. he then referred me to a Retina specialist who did some additional tests.
I tend to be very skeptical of diagnosis made by optometrists for the reasons I noted above… But at least yours did the right thing and referred you to an actual Doctor…
That’s interesting Brian. Does your endocrinologist recommend that you see the Ophthalmologist?
I get dilated Retinal photos taken every 6 months. Up until this year, I had never had any abnormalities noticed. This year they have found in one eye a small deposit of lipids, which according to my optometrist is the very, very early stages of non-proliefartive retinopathy. He said at this stage there is no need to go to an Ophthalmologist but now I question if I should just be doing that on a regular basis with other checkups I get…
IMO the answer to your question is an unequivocal yes-- I would ONLY see opthalmologists for medical exams of your eyes and will never again see an optometrist for that purpose. If you just want a new glasses rx, an optometrist fits the bill nicely.
My Optomotrist and Retinal Specialist are all part of the same Cleveland Clinic Medical group. I see the Retina specialist once a year and Optomotrist once a year, so I get tested every 6 months to watch for changes.
I’m hoping for your sake that the retina “specialist” is an ophthalmologist (MD). Since my daughter’s diagnosis with Type 1, it’s ophthalmologists only!